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Published on: August 4, 2010
Gentamicin-associated acute kidney injury
Nicholas M Selby1, Susan Shaw, Nicholas Woodier
1Department of Renal Medicine, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK.
QJM : Monthly Journal of the Association of Physicians
|October 13, 2009
Summary
Gentamicin-associated acute kidney injury (AKI) affects nearly a quarter of patients, with higher RIFLE stages correlating to increased mortality risk. This highlights a significant clinical problem requiring attention.
Area of Science:
- Nephrology
- Pharmacology
- Clinical Medicine
Background:
- Gentamicin is a widely used antibiotic with known nephrotoxic potential.
- The incidence and clinical impact of gentamicin-associated acute kidney injury (AKI) using the RIFLE criteria remain largely uncharacterized.
Purpose of the Study:
- To determine the incidence of gentamicin-associated AKI in a hospital setting.
- To evaluate the predictive value of the RIFLE (Risk, Injury, Failure, Loss, End-stage) classification for patient outcomes.
Main Methods:
- A retrospective observational study was conducted on 228 patients treated with gentamicin over one month.
- Data collected included serum creatinine, gentamicin levels, co-morbidities, and additional renal insults.
- Patients were classified according to RIFLE criteria for AKI.
Main Results:
- AKI occurred in 24.4% of patients, with 17.7% classified as 'Risk', 4.3% as 'Injury', and 2.4% as 'Failure'.
- Independent predictors for AKI included elevated gentamicin levels (>2 mg/l) and higher baseline serum creatinine.
- In-hospital mortality was significantly higher in patients with AKI (45.1% vs. 19.1%) and increased with each RIFLE stage.
Conclusions:
- Gentamicin-associated AKI is a common and serious complication.
- The RIFLE classification effectively predicts in-hospital mortality risk in patients with gentamicin-induced AKI.
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